| National Provider Identifier [NPI]: | 1851353247 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7421 HIGHWAY N |
| Street Address 2 Of The Provider | |
| City Of The Provider | DARDENNE PRAIRIE |
| Zip Code Of The Provider | 633687014 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 633 |
| Number Of Medicare Beneficiaries | 136 |
| Total Submitted Charge Amount | 61523 |
| Total Medicare Allowed Amount | 41658.43 |
| Total Medicare Payment Amount | 28110.95 |
| Total Medicare Standardized Payment Amount | 29297.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 156 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 3045 |
| Total Drug Medicare AllowedAmount | 826.65 |
| Total Drug Medicare PaymentAmount | 773.52 |
| Total Drug Medicare Standardized Payment Amount | 773.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 477 |
| Number Of Medicare Beneficiaries With Medical Services | 136 |
| Total Medical Submitted Charge Amount | 58478 |
| Total Medical Medicare Allowed Amount | 40831.78 |
| Total Medical Medicare Payment Amount | 27337.43 |
| Total Medical Medicare Standardized Payment Amount | 28523.87 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 70 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 58 |
| Number Of Male Beneficiaries | 78 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0521 |